Grans, Plasma, Cryo, Concentrates Flashcards
Granulocyte Concentrates:
-Storage
20-24 C up to 24 hours
-withOUT agitation
Granulocyte Concentrates:
-Each unit contains (3)
- WBC (10^10)
- Platelets (large number)
- RBCs (contaminating)
Granulocyte Concentrates:
-Indications (2)
- Neutropenic Sepsis
- Fungal infections unresponsive to standard therapy
Granulocyte Concentrates:
- Dosing
- ABO crossmatch
- Irradiated
- Leukoreduced
- No agreed upon dose
- Must be ABO crossmatch compatible w/ recipient
- Must be irradiated
- NEVER leukoreduced
Plasma:
- FFP storage
- Expiration (2)
-(-)18 degrees C
Expires:
-1 year at -18 C
-7 years at
FP24 is depleted of what factors (vs FFP)?
-Useful for all indications for FFP, except what?
Factors V(5)/VIII(8) -DIC
Granulocyte Concentrates:
-Each unit contains (3)
- WBC (10^10)
- Platelets (large number)
- RBCs (contaminating)
Plasma:
-FP24 preparation
Plasma frozen between >8 hours and <24 hours.
Plasma/FFP compatibility:
- 1st choice
- 2nd choice
Contains ABO antibodies; should be compatible with recipient red cells.
- ABO identical - 1st choice
- Type AB (universal plasma donor)* - 2nd choice
*Contains NO antibodies
FFP:
- must be thawed at what temp?
- after thawing expires?
Thawed at 30-37 C
-Expires in 24 hours
FFP:
- Total Volume
- Amt. of Coag Factors
- Fibrinogen
200 mL
- 1 IU/mL of ALL coagulation factors*
- 2 mg of fibrinogen/mL
*1 IU of coagulation factor is that amount contained in 1 mL of normal plasma
Plasma/FFP Indications. (4)
- Multiple factor deficiencies
- C1 Esterase Inhibitor deficiency
- Warfarin Skin Necrosis (Rapid infusion)
- Warfarin reversal (last resort)
What is the appropriate treatment for single factor deficiencies? (step-wise; 3)
- Recombinant/Factor concentrates
- Cryoprecipitate
- Plasma
FFP Dosing:
- Adults
- Neonates
- 2 units for Adults
- 10-15 mL/kg for neonates (and adults)
Cryoprecipitate Indications/Uses. (5)
- DIC/Fibrinogen deficiency (<100 mg/dL)
- Uremic pts w/ bleeding
- Factor XIII (13) deficiency
- vWD (1st - DDAVP)
- Fibrin “glue”
Plasma/FFP compatibility:
- 1st choice
- 2nd choice
Contains ABO antibodies; should be compatible with recipient red cells.
- ABO identical - 1st choice
- Type AB (universal plasma donor)* - 2nd choice
*Contains NO antibodies
Plasma/FFP compatibility:
-Rh type
Donor Rh type should not affect product choice
-No need to give RhIg
How do you make Cryoprecipitate?
- Thaw FFP to 1-6 C
- Centrifuge
- Precipitate forms (cold insoluble portion of plasma)
- Remove thawed plasma
- -18C within 1 hour
Cyroprecipitate - Expiration:
- Storage
- After thawing
- 1 year at -18C
- 6 hours, unless pooled, then expires in 4 hours
Cryoprecipitate:
- Total Volume
- Fibrinogen
- Factor VIII (8)
- Also rich in what (2)
- Does NOT contain (1)
Cryprecipitate:
- 15 mL (total volume)
- > 150 mg Fibrinogen
- 80 IU of Factor VIII (8)
- vWF/FactorXIII (13)
- NO Factor V (5)
T/F: One unit of cryoprecipitate contains the amount of factors present in 1-2 units of FFP, but in a significantly small volume.
True
*1 unit of FFP has the volume of 20 units of cryo
What is the half-life of Factor VIII (8)?
12 hours
Cryo should not be used alone in DIC, what should also be given?
FFP
*Cryo lacks certain factors, notably F5
What is the usual dose of Cryo in adults?
10 bags, pooled
What is the expected rise in fibrinogen?
- 1 unit of Cryo
- 1 dose of Cryo (10 bags)
- 7 mg/dL
- 70 mg/dL
Factor VII (7) concentrate indications. (3)
- Factor VII (7) deficiency (Inherited)
- Anti-FVIII (8) inhibitors
- Anti-FIX (9) inhibitors
Factor VIII (8) concentrate indications. (2)
- Hemophilia A (treatment/prophylaxis)
- von Willebrand disease*
*Humate-P formulation contains sufficient vWF
Factor IX (9) concentrate:
- Indication
- Half-life
- Intravascular Recovery
- Hemophilia B
- T1/2 - 24 hours
- Intravascular recovery - 50%*
*Factor VIII (8) Intravascular recovery is 100%
Estimating the dose of FVIII (8):
- 30% activity
- 50% activity
- 100% activity
Estimating the dose of FVIII (8):
- 30% activity: 15 IU/kg
- 50% activity: 25 IU/kg
- 100% activity: 50 IU/kg
